1.

Current obstetric practice strives to

avoid difficult vaginal deliveries and
the clinicians skill resides mainly in
precisely identifying the fetal head
station at which forceps or ventouse
should be applied.
Digital transvaginal examination
remains the gold standard for
obtaining this information, but it is a
subjective evaluation with several
Limitations.

Olah KS. Reversal of the decision for caesarean section in the second stage of labour on the basis of consultant vagina
assessment. J Obstet Gynaecol 2005; 25: 115116.
2. Dupuis O, Silveira R, Zentner A, Dittmar A, Gaucherand P,Cucherat M, Redarce T, Rudigoz RC. Birth simulator: reliability
of transvaginal assessment of fetal head station as defined by the American College of Obstetricians and Gynecologist
classification. Am J Obstet Gynecol 2005; 192: 868874.
3. Buchmann E, Libhaber E. Interobserver agreement in intrapartum estimation of fetal head station. Int J Gynaecol Obstet
2008; 101: 285289.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Intrapartum ultrasonography is
the most accurate tool for
assessing the position of the
fetal occiput.
1.

Akmal S, Kametas N, Tsoi E, Hargreaves C, Nicolaides KH. Comparison of transvaginal digital examination with intrapartum s
fetal head position before instrumental delivery. Ultrasound Obstet Gynecol 2003; 21:437440.
2. Zahalka N, Sadan O, Malinger G, Liberati M, Boaz M, Glezerman M, Rotmensch S. Comparison of transvaginal onography with
transabdominal sonography for the determination of fetal head position in the second stage of labor. Am J Obstet Gynecol 20

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Methods.
Transabdominal
Transperineal
Translabial
Transvaginal

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Occiput posterior (OP) is the most common

malposition
during labor. OP at delivery has been reported
to be
associated with negative events such as
prolonged labor
assisted vaginal delivery (vacuum or
forceps),
third and fourth degree perineal lacerations,
blood loss greater than 500 mL,
Chorioamnionitis
Its incidence has been reported to be between
postpartum wound infection
4 and 10% during the second stage of labor
and at delivery

1. Senecal J, Xiong Xu, Fraser WD. Pushing EarlyOr Pushing Late with Epidural study group. Effect of fetal
position on secondstage duration and labor outcome. Obstet Gynecol 2005; 105:763772.
2. Ponkey SE, Cohen AP, Heffner LJ, Lieberman E. Persistent fetal occiput posterior position: obstetric
outcomes. Obstet Gynecol 2003; 101: 915920.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

U2k jam
04.00

U2k jam 05.00

U2k jam
06.00
Workshop 2nd and 3rd trimester
ultrasound. 31 July 2016,
Palembang.

Angle of
progression

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Translabial/perineal 3D
ultrasound

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Points to remember:
Point of reference
Angle of descent
Any caput succedaneum or
moulage

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Terima kasih

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.

Workshop 2nd and 3rd trimester

ultrasound. 31 July 2016,
Palembang.